Health and Social Care Bill: Report stage day four update

The House of Lords continued to scrutinise the Health and Social Care Bill yesterday (Wednesday 29 February) in day four of report stage. Members voted on an amendment proposing clinical commissioning groups are governed by independently appointed non-executives. The vote failed and resulted in a government win.

Members of the House began by agreeing the three tabled amendments to Clause 22 covering the NHS Commissioning Board's duties.

Baroness Williams of Crosby (Liberal Democrat) suggested Amendment 75 to Clause 24 which covers the establishment of clinical commissioning groups. After some debate Baroness Williams withdrew the amendment: 'I asked the minister for an unqualified assurance that all people resident in England would be covered by a clinical commissioning group, and I have to say that I think he gave me that assurance.'

Amendment 76 also to Clause 24 went straight to a vote without debate. Lord Hunt of Kings Heath (Labour) said: 'if you give enormous power to professionals who can take advantage financially from their decisions, you need strong corporate governance safeguards. The best safeguard is to have independent appointment of non-execs, who should be in a majority' on the NHS Commissioning Board.' The amendment was not agreed after the House voted 282 to 185.

Baroness Barker (Liberal Democrat) also suggested an amendment to Clause 24 which was agreed by the House. Amendment 79A clarified that clinical commissioning groups must maintain registers of interest and make these available to the public. Also that the NHS Commissioning Board must publish best practice guidance for them to follow.

During the debate the government assured the House that public health funding has been ring fenced and fluoridation schemes can be considered by individual local authorities when addressing responsibilities to dental health.

Lord Patel of Bradford (Crossbench) made a convincing argument to clarify the need for people discharged from mental health institutions to receive after-care services and a commitment that clinical commissioning groups and social service authorities providing this service will work together. He said: ' joint duty is essential, because it means that the patient is more likely to get access to the right kind of integrated health and social care services which they need and, most importantly, that the patient has an enforceable right to those services.'

Baroness Northover (Liberal Democrat) on behalf of the government assured the House that they would accept the amendment but 'will need to bring forward a few technical amendments at third reading.'

Lords will continue detailed line by line examination in report stage day five on Tuesday 6 March.

Health and Social Care Bill: Key areas

Establishes an independent NHS Board to allocate resources and provide commissioning guidance.
Increases GPs’ powers to commission services on behalf of their patients.
Strengthens the role of the Care Quality Commission.
Develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS.
Cuts the number of health bodies to help meet the government's commitment to cut NHS administration costs by a third, including abolishing Primary Care Trusts and Strategic Health Authorities.

Catch up on the Health and Social Care Bill so far

The House of Lords Constitution Committee report

The Constitution Committee published a follow-up report calling for changes to the Health and Social Care Bill to ensure that ministerial responsibility to Parliament and legal accountability for the NHS are not diluted.

Read the House of Lords Constitution Committee report

What is the report stage?

Report stage in the chamber gives all members of the Lords further opportunity to consider all amendments (proposals for change) to a bill. It usually starts at least 14 days after committee stage. It can be spread over several days (but usually fewer days than at committee stage).

Before report stage takes place

The day before report stage starts, amendments are published in a Marshalled List – in which all the amendments are placed in order.
On the day, amendments on related subjects are grouped together and a list (“groupings of amendments”) is published.

What happens at report stage?

Detailed line by line examination of the bill continues.
Votes can take place and any member can take part.

After report stage - third reading

If the bill is amended it is reprinted to include all the agreed amendments.
The bill moves to third reading for the final chance for the Lords to debate and amend the bill.
More about third reading.

Further information

Detailed line by line examination of the separate parts (clauses and schedules) of a bill takes place during report stage.

Passage of a bill: report stage

Find out more about watching House of Lords debates.

Visiting Parliament: Attend debates and meetings